Pages

Friday, 9 December 2016

Okay, today's post isn't an article about neuropathy written to wreck our brain cells but an image that represents how you may feel at any given time of the day. There are lots of pain scales around. You may have been presented with one by a doctor or specialist and were asked to point out where you sit on it. Your eventual treatment may have depended on that ridiculous diagnostic tool but as every neuropathy patient knows, the pain, discomfort and other symptoms are practically never consistent and you can go from mild to wild and every stop in between during the course of the day. At least this pain scale brings a little humour to the proceedings and (surprisingly) may be more accurate than many of the standard pain measurement tests that we're given. if it does nothing else than cause the corners of your mouth to wrinkle...then it's done its job! What do you think? Can you come up with something better?An alternative pain scaleDecember 9th 2016

Thursday, 8 December 2016

Today's post from cbc.ca (see link below) highlights one of the new problems associated with medical cannabis for nerve pain (amongst other conditions) and that is the stigma associated with die-hard cannabis smokers. Conservative thinkers see them as lazy and ineffectual; practically a danger to society! However, as this article suggests: as more and more areas legalise the drug for medical purposes, it may be up to the medical cannabis producers and retail outlets to change the image (however inaccurate) in order to promote the undoubted qualities cannabis can have. There will always be opposition of course; from those who have never tried it and those who fortunately for them, don't need it. It may be a long road ahead but the progress so far is nothing less than astonishing!

For many users, the high they get is an unwanted side-effectMedical marijuana is used for, among other things, relieving pain, stimulating appetite, relieving nausea and relaxing patients suffering from PTSD or psychological other trauma. (Robert F. Bukaty/Associated Press)

About The Author

Peter Thurley is a Kitchener, Ont. based writing and communications consultant, helping non-profits, small businesses and political action groups effectively engage with stakeholders. A relatively new medical cannabis user, he has written further reflections on the politics of cannabis at peterthurley.ca.

When people hear that someone uses cannabis, they often give a nudge nudge​ wink wink and say, "Lucky you, getting high on weed, eh?"

I usually chuckle and reply that the official scientific name of the plant is "cannabis," and that it is medicine. For me, it's used to dull chronic nerve pain left after an invasive surgery to repair burst bowels and remove a 25-pound desmoid tumour.

It can also be used as an appetite stimulant, it quickly kills nausea and it relaxes anyone who needs to deal with frightening flashbacks of their time in hospital.

Different strains of marijuana are on the menu at a dispensary in Ottawa. (Stu Mills/CBC)

​Once the NDP's critic for veterans affairs, Stoffer, who is now the public spokesperson for Nova Scotia-based Trauma Healing Centers, quipped that the 10 grams a day of cannabis allowed under Veterans Affairs Canada rules is "an awful lot of marijuana to give one person." Veterans Affairs Minister Kent Hehr seems to agree, and announced this week that the limit will be scaled back to three grams.

In his interview, Stoffer added that veterans should be subject to a full lifestyle examination before being granted access to cannabis, suggesting that some might be using it simply to get high.Novelty wears off

The novelty of being a cannabis consumer wears off quickly. For many medical cannabis users, the potential high is an unwanted side-effect.

So it was disappointing to read Stoffer repeat long-debunked myths about medical cannabis users looking for a buzz rather than relief in his thinly veiled comments about "lifestyle monitoring." That's simply not true.

And while the federal government does play a role in how veteran health care dollars are spent, it does not have the right to come between a patient and their doctor — nor should Veterans Affairs Canada be asking questions about a patient's lifestyle, financial status or eating habits, as suggested by Stoffer. They don't do it now, nor should they start. If they don't do it for other prescription medications, why should they do it for cannabis?Lessons learned about legalized marijuana from Colorado's chief medical officer

As Canada moves towards full legalization, it will be incumbent on the burgeoning cannabis industry to take steps to explain the various ways of consuming cannabis. Extractions, for instance, take much more plant matter to produce than other methods such as smoking or vaporizing.

Indeed, according to Maxim Zavet, CEO at Emblem Cannabis, it may be that veterans are relying increasingly on oils instead of smoking the dried flower — something that requires more plant material and may not contain psychoactive ingredients like THC. Stoffer acknowledged that fact in a follow-up call I had with him, but he held fast to his position, saying, "Everyone knows that 10 grams is a lot."

Cannabis can be consumed in several different ways, like adding cannabis oil to a smoothie, as chef Cody Lindsay does here. (CBC)

Like me, Michael Blais, of Canadian Veterans Advocacy, respects Stoffer and applauds the work he did in the House of Commons. But he also agreed that these long-standing stigmas about medical cannabis must fall, especially for Canada's veterans, who have already given so much for the sake of our nation. "There aren't many of us who have sustained a battle injury," he reminded me.Cooking with cannabis and what could be on Canada's menu

In 2017, Canada will become the first G7 nation to fully legalize cannabis use, both medically and recreationally. It would be a shame if Stoffer's cannabis myths — relics left over from the failed war on drugs — were to further disadvantage our veterans, right when they need our help the most.

This column is an opinion - for more information about our commentary section please read this editor's blog and our FAQ. http://www.cbc.ca/news/opinion/medical-marijuana-stigma-1.3861027

Wednesday, 7 December 2016

Today's post from nytimes.com (see link below) is an article that may help clear up one of the many problems people have with the language of neuropathy. A patient new to the disease may be diagnosed in terms that leave him or her bewildered and because the neurological vocabulary used by doctors is so broad, you may not be aware precisely what your diagnosis means in relation to other forms of neuropathy. Take the subject of this article for instance. You'd be forgiven for thinking that 'metabolic' neuropathy is a completely different form of nerve damage to other common neuropathies, when in fact it's another general term describing pretty much the same symptoms and problems that millions of others have. Metabolism (change) is life-sustaining chemical transformations within the cells of living organisms. There is an argument that all neuropathies are metabolic in nature but the word in itself shouldn't confuse you:- if you have metabolic neuropathy, you have neuropathy, in the same way that millions of others have. It's very often used in connection with diabetes and is therefore attached to diabetic neuropathy because that's the most common neuropathic cause. Diabetes is a metabolic disease, because it affects the body’s ability to capture glucose from food for use by the cells. You're probably more confused than ever now (I haven't explained it very well - apologies😓) but the symptoms and treatment are very much the same as other forms of neuropathy, peripheral or not and metabolic or not.

Metabolic NeuropathiesMetabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body.

CausesNerve damage can be caused by many different things. Metabolic neuropathy may be caused by:A problem with the body's ability to use energy, often due to a nutritional deficiency Dangerous substances (toxins) build up in the body Diabetes is one of the most common causes of metabolic neuropathies. People who are at the highest risk of nerve damage from diabetes include: Those with damage to the kidneys or eyes Those with poorly controlled blood sugar

Some metabolic disorders are passed down through families (inherited), while others develop due to various diseases. Symptoms

These symptoms occur because nerves cannot send proper signals to and from your brain:Difficulty feeling in any area of the body Difficulty swallowing Difficulty using the arms or hands Difficulty using the legs or feet Difficulty walking Pain, burning, pins and needles, or shooting pains in any area of the body (nerve pain) Weakness in the face, arms, legs, or other area of the body

Usually, these symptoms start in the toes and feet and move up the legs, eventually affecting the hands and arms.

For most metabolic neuropathies, the best treatment is to correct the metabolic problem.

Vitamin deficiencies are treated with diet or injections. Abnormal blood sugar or thyroid function may need medication to correct the problem. Alcoholic neuropathy is treated with alcohol abstinence.

In some cases, pain is treated with medications that reduce abnormal pain signals from the nerves (duloxetine, gabapentin, pregabalin). Lotions, creams, or medicated patches can provide relief in some cases.

The outlook mainly depends on the cause of the disorder. In some cases, the problem can easily be treated. In other cases, the metabolic problem cannot be controlled and nerves may continue to become damaged.

If you already have a metabolic problem, regular doctor visits can help control the problem and reduce the chance of further nerve damage.

Patients who already have metabolic neuropathy can reduce the risk of some complications. A foot doctor (podiatrist) can teach you how to inspect your feet for signs of injury and infection. Proper fitting shoes can lessen the chance of skin breakdown in sensitive areas of the feet.References

Tuesday, 6 December 2016

Today's post from spacecoastdaily.com (see link below) revisits an older animal poison and its potential for alleviating nerve pain. We're still on the tip of the iceberg regarding the use of venoms from the natural world to help with chronic pain but as more money is ploughed into research, it's becoming clear that there is an enormous potential in the poisons of spiders, fish, snakes, scorpions and the rest, to significantly aid us in controlling pain in humans. In this article, the venom-based, pump-action fluid Prialt is used (Prialt (or Zoconitide) is
a non-narcotic synthetic form of a naturally occurring venom
(neurotoxin) found in the Conus Magus snail) as an effective alternative to standard pain medications. This also means a lessened future reliance on chemical pills. Yet again another by-product of the current hysteria about opioids and overdosing - pharmaceutical companies are beginning to see the financial benefit in investing in alternative sources of analgesics. It's like they say: every disadvantage has its advantage😌 By using the search button to the right of this blog, you will come across more articles about this subject.

Broadly speaking, there are two types of pain. There is nociceptive pain, which is caused by tissue injury or inflammation. This pain tends to be temporary, lessening as the tissues heal.

THE INTRATHECAL PUMP delivers Prialt directly into the spinal space. The entire pump system is placed under the skin, and the pump is refilled every 60- 90 days by placing a needle through the skin into the pump. (Shutterstock image)

The second type of pain is far more difficult to manage and is called neuropathic pain. This pain is caused by trauma to the nervous system that directly injures nerves or interferes with the ability of nerves to process pain signals.

The intrathecal pump delivers Prialt directly into the spinal space. The entire pump system is placed under the skin, and the pump is refilled every 60- 90 days by placing a needle through the skin into the pump.

Prialt (or Zoconitide) is a non-narcotic synthetic form of a naturally occurring venom (neurotoxin) found in the Conus Magus snail. The snail’s venom was known since antiquity as a topical remedy for burns, abscesses and other wounds.

Neuropathic pain often does not respond well to oral narcotics, resulting in some patients being placed on escalating doses.

The most concerning aspects of high dose narcotics are side effects (which increase with the dose), tolerance (loss of effect with time requiring increasing doses), hyperalgesia (escalating doses paradoxically increasing pain), physical dependence (withdrawal if narcotics are suddenly stopped) and, rarely, addiction (uncontrolled use and craving).

Naturally Occuring Venom

Prialt (or Zoconitide) is a non-narcotic synthetic form of a naturally occurring venom (neurotoxin) found in the Conus Magus snail. The snail’s venom was known since antiquity as a topical remedy for burns, abscesses and other wounds.

Cone snails are hunting animals, which use neurotoxins to paralyze their prey. The snails use their harpoon like limb to grab, inject, and then consume the fish after it is paralyzed. Prialt is now FDA approved specifically for neuropathic pain.

In fish, prialt is a paralyzing agent, but in humans it reduces or stops pain transmission.

If taken by mouth prialt would be rapidly and completely destroyed by our digestive enzymes. Therefore, Prialt is only delivered by the Medtronic pain pump directly into the spinal canal fluid.

In the spinal fluid the Prialt molecules block pores on pain sensing nerve cells, which stops the flow of calcium into the cells. This reduction of calcium flow prevents the nerve cells from sending signals to the brain, reducing the perception of pain.

When used in the pain pump, Prialt can often reduce neuropathic pain allowing the patient to significantly reduce or wean off narcotics.

The pain management physician determines that a patient is a good candidate for Prialt by administering a test dose in which a small amount of Prialt is injected into the spine under x-ray guidance.

The patient is then observed closely and pain levels are recorded for the next several hours. Then the patient is asked to perform specific exercises to determine the drug’s effect on the pain. If greater than 70-80 percent of the pain is reduced, the trial of Prialt is considered successful.

After the successful test dose with Prialt, the patient may be scheduled for implantation of a Medtronic intrathecal pump.

Pump Implantation

The pump implantation is a minor outpatient surgical procedure, which provides the patient with a constant infusion of the pain relieving Prialt. After implantation, the pump is programmed to deliver slowly increasing amounts of Prialt to minimize drug side effects.

THIS SEQUENCE of events shows a cone snail catching, injecting, paralyzing, and swallowing a helpless fish.

As the Prialt dose increases and pain is reduced, narcotics are simultaneously weaned.

If you have a severe pain condition that has failed all other standard conservative therapies, consider undergoing evaluation by a pain management specialist to determine if this mode of direct intrathecal medication therapy is appropriate for you.

Facts About Cone Snail

Less than one percent of the more than 500 species of cone snails have been studied. Each snail produces multiple neurotoxins in its venom. Some scientists feel the cone snails hold more promise for new medicines than any other species in nature.

Different snail toxins in preclinical trials already hold promise for new treatments for pain, Parkinson’s Disease, and depression. The snails are found in the warm tropical coral reefs.

Unfortunately the coral reefs are being destroyed; over 26 percent of the reefs are damaged beyond repair and between 30 to 50 percent are severely degraded. If the reefs are lost, we also lose the potential cure for many diseases.

Monday, 5 December 2016

Today's post from aboutlawsuits.com (see link below) takes us back to an older problem for potential neuropathy sufferers and that is nerve damage cause by fluoroquinolone antibiotics. Despite it seeming like an age since this was first highlighted, the subject is finally reaching the courts and hopefully, pharmaceutical companies will now be held responsible for the damage they've caused (and continue to cause). This article is a news update but also a continued warning about fluoroquinolones and nerve damage. It's a warning you would do well to heed because doctors across the world still blithely prescribe these pills, seemingly unaware of the dangers. There are many other articles on this subject here on the blog - use the search button to find them and then make your own minds up (or at least have a serious discussion with your prescribing doctor). There are always alternatives to fluoroquinolones (the main brand names are mentioned below) but you may need to point this out to your doctor.

The complaint (PDF) was filed late last month in the U.S. District Court for the Western District of Oklahoma, naming Bayer Healthcare, Merck & Co., Johnson & Johnson and its Janssen subsidiary as defendants.

Each of the plaintiffs indicate they developed a form of nerve damage known as peripheral neuropathy, with some of the plaintiffs experiencing fatal injuries.

Peripheral neuropathy involves damage to the nerves that may impair sensation, movement and other aspects of health. This typically leaves users with persistent pain, burning, tingling, numbness, weakness and sensitivity to light touches, temperature and motion in the arms and legs, as well as other problems that cause a major disruption to daily activities.

The case joins hundreds of other Levaquin lawsuits, Avelox lawsuits and Cipro lawsuits filed on behalf of individuals nationwide, each raising similar allegations that the drug makers failed to provide adequate warnings for users and the medical community about the risk of permanent peripheral neuropathy from the antibiotics, which may continue long after the medication is no longer used.

“[R]ather than warning patients and physicians that the use of Fluoroquinolones may result in permanent nerve damage, Defendants instead adopted a warning that misleadingly indicated such damage was rare and in any event could be avoided by simply discontinuing the drug upon the onset of certain symptoms,” the joint lawsuit filed last month on behalf of nearly 50 people states. “Defendants’ failure to adequately warn physicians resulted in (1) patients receiving Fluoroquinolones instead of another acceptable and adequate non-fluoroquinolone antibiotic, sufficient to treat the illness for which Plaintiffs presented to the provider; (2) and physicians failing to warn and instruct consumers about the risk of peripheral nervous system injuries associated with Fluoroquinolones.”

Given the risk of nerve damage and other injuries associated with the antibiotics, the FDA issued a new drug safety communication in May 2016, urging doctors not to prescribe Avelox, Levaquin, Cipro or other fluoroquinolones for many common infections that are uncomplicated and have other available treatment options, indicating that the risks associated with the antibiotics outweigh the benefits. The federal regulatory agency considered available information on the risk of peripheral neuropathy, tendon ruptures, retinal detachments and other health concerns linked to the drugs at that time. Antibiotic Peripheral Neuropathy Lawsuits

This recent complaint will be consolidated with about 600 other claims pending in the federal court system, which are centralized for pretrial proceedings before U.S. District Judge John R. Tunheim in the District of Minnesota, as part of an MDL, or Multidistrict Litigation.

Given similar questions of fact and law raised in the lawsuits over peripheral neuropathy from the antibiotics, the cases are being coordinated during discovery, bellwether trials and other pretrial litigation.

Judge Tunheim will hold a “Science Day” in the peripheral neuropathy litigation in January 2017, at which time the parties will present scientific information in a non-adversarial manner designed to educate the court about issues that will come up in the litigation.

It is expected that a small group of cases in the MDL will ultimately be selected for a series of “bellwether” trials, which are designed to help the parties gauge how juries may respond to certain evidence and testimony that is likely to be repeated throughout a number of claims. While the outcomes of these early trial dates are not binding on other claims, they may help facilitate potential peripheral neuropathy settlements for individuals who have been left with the severe and debilitating nerve damage from Avelox, Levaquin or Cipro.

As the peripheral neuropathy cases move forward, the drug makers also face an increasing number of aortic aneurysm lawsuits and aortic dissection lawsuits that are being investigated by individuals nationwide, as recent studies have suggested that medications may cause collagen degradation issues throughout the body, impacting the aorta.

Sunday, 4 December 2016

Today's post from dressamed.com (see link below) is another article by well-known neuropathy expert, Dr. John Hayes Jr. This time he talks about the relationship between digestive problems and autonomic neuropathy (you know, the one where your involuntary functions are affected by nerve damage). He focusses on the results of stomach surgery which may lead to nerve damage but in fact, autonomic neuropathy affecting your digestive system can arise irrespective of the cause. It's a useful article because many of us do have digestive problems, especially as we get older - these may result in weight gain, or weight loss, or general discomfort but identifying the culprit is a nightmare. If you already have neuropathy, you may well suggest to your doctor that he consider autonomic neuropathy: there's a good chance that nerve damage may be the cause of your symptoms.

Everything went really well with the surgery and now you’re back home and on your way to your new life and brand new you.

You started to lose weight almost immediately and you couldn’t be happier with the results.

You knew you’d have some side effects[1] but you really didn’t expect anything you couldn’t handle. But you never expected:Heartburn Bloating Nausea and/or vomiting Difficulty in swallowing because your esophagus no longer functions properly Inability to empty your stomach Diarrhea Constipation

None of these digestive problems are pleasant. And what’s even worse is that they can last from days to weeks on end.

You knew you needed to take off the weight but it’s beginning to feel like it might not have been worth it.

They warned you about possible side effects but one they may not have mentioned what could be causing one or several of your symptoms.

Your problems could be a result of Gastrointestinal or G.I. Autonomic Neuropathy.Exactly What Does That Mean?

It means that your body is suffering from nutritional deficiencies caused by the lack of certain nutrients and vitamins. The bypass surgery or lap band procedure may have stopped your body from taking in too much food, but it also substantially reduced the amount of nutrients and vitamins you’re getting from your food.

You no longer take in enough food with the nutrition your body needs[2]. When that happens, the body begins to break down. One of the many issues you can develop due to what is basically malnutrition is G.I. Autonomic Neuropathy. The nerves; specifically the vagus nerve, is damaged by the lack of nutrition and it begins to malfunction. That means difficulty in digesting food, difficulty in swallowing, and inability to eliminate waste properly…

Basically an inability of the digestive system to do anything it was designed to do.

Before the advent of gastric bypass surgery and lap band procedures, most people who developed G.I. Autonomic neuropathy or other types of neuropathy were diabetics, alcoholics or they live in countries where malnutrition was common.

Now gastric bypass surgery has brought on a whole new subset of patients who suffer from G.I. Autonomic Neuropathy.The Nutrients You Probably Lack

G.I. Autonomic Neuropathy is usually caused by deficiencies in: Vitamin B1 or Thiamine Vitamin B3 Vitamin B6 Vitamin B12 Vitamin E Many of the symptoms caused by your G.I. Autonomic Neuropathy can be lessened and possibly even controlled by a healthy diet and management of whatever underlying condition you have that could be contributing to your neuropathy. What If You’re Not a Gastric Bypass Patient But You Have These Symptoms

What if you haven’t had gastric bypass or lap band surgery but you still have the symptoms we talked about above? If you have A history of alcohol abuse Hepatitis C Crohn’s Disease Celiac Disease

And you’re having the problems we discussed above contact your doctor immediately. Ask him to test to make sure that you are indeed suffering from nerve damage that could be linked to any of these causes. Once that diagnosis has been made, ask them about treatment options.Treatment Options

A highly skilled medical professional well versed in diagnosing and treating nerve damage is your best place to start for treatment of your G.I. Autonomic Neuropathy. An excellent place to start is with a neuropathy clinician. They have had great success in treating patients with your symptoms using a multipronged approach that includes:Care and correction for your muscular and skeletal systems Treatment for any underlying medical problems Nutrition education and diet planning A step by step exercise regimen Medication as needed or necessary

If you have a confirmed diagnosis of Gastrointestinal Autonomic Neuropathy or think you may have it, you don’t have to just live with it. In fact, just living with it could be downright dangerous due to intestinal blockages, continued malnutrition, etc. You may also contact us today for information on how G.I. Autonomic Neuropathy can be treated, your suffering lessened and exactly how to find a neuropathy clinician in your area.

Dr. John Hayes, Jr. is an Evvy Award Nominee and author of “Living and Practicing by Design” and “Beating Neuropathy-Taking Misery to Miracles in Just 5 Weeks!”. His work on peripheral neuropathy has expanded the specialty of effective neuropathy treatments to physicians, physical therapists and nurses. A free Ebook, CD and information packet on his unique services and trainings can be obtained by registering your information at neuropathydr.com. To book interviews and speaking engagements call 781-754-0599.https://www.dressamed.com/root/could-your-digestive-problems-be-caused-by-autonomic-neuropathy/

Saturday, 3 December 2016

Today's post from seattleorganicrestaurants.com (see link below) doesn't seem to have medical or scientific authorship but does refer to its sources. The reason I say that is because it makes some astonishing claims for the healing powers of Turmuric (Curcuma depending on where you live). Now even if only a tenth of these are bordering on the truth, it still comes over as a wonder-spice. Turmeric has long been advanced as a help for nerve pain and its symptoms (see other posts via the search button on this blog), so any lengthy article about the spice is certainly worth a look for neuropathy patients. I suggest you read it and then make your own minds up (maybe after also discussing it with a health professional or a qualified herbalist). You do slightly wonder why India and south east Asia in general isn't the healthiest place in the world, considering how much turmeric is used in their diet...but then again, look at the populations, that may be evidence enough😏

Studies show that turmeric can be as effective as 14 pharmaceutical drugsSeattle Organic Restaurants 2016

Turmeric and saffron are the two prominent spices used in South Asian and Middle Eastern dishes including Persians and Indians. Persian saffron and turmeric are very well-known because of their unique quality and taste. For thousands of centuries, curcumin known as turmeric has been used for its healing and medicinal properties. Based on an informative article written by greenmedinfo.com, turmeric is as effective and if not even better than 14 different pharmaceutical drugs in the market.Here are some of the scientific studies about the health benefits of turmeric:

A 2004 study published in the journal Atherosclerosis shows that turmeric can reduce the level of bad cholesterol and fight the plaque buildup in the arteries which is an important factor in developing heart diseases. Another 2008 study published in the journal Drugs in R & D shows that turmeric extract is as beneficial as the drugs used for inflammation and type 2 diabetics.

Besides lowering the bad cholesterol levels and fighting plaque buildup in the arteries, turmeric can improve the cardiovascular health. A study published in 2012 discovered that both exercise and curcumin supplements can significantly improve the cardiovascular health. In conclusion, turmeric can be as effective as conventional drugs such as Lipitor and atorvastatin (for lowering cholesterol and improving heart health), without having the side effects.

Inflammation is the root of many chronic diseases including cancer, arthritis, dementia and heart disease. Poor eating habits and high intake of omega 6 versus omega 3 is the leading cause of chronic inflammation. Studies show that turmeric is a great source of anti-inflammatory.

A study published in the journal Phytotherapy Research showed that the powerful antioxidants in turmeric can be as effective as steroid in treatment of chronic anterior uveitis (an inflammatory eye disease). Another study published in Critical Care Medicine showed that turmeric is as effective as corticosteroid drug known as dexamethasone and can provide relief for inflamed areas of the body.

Also a study published in the journal Oncogene discovered that curcumin is as effective as other anti-inflammatory drugs that can kill cancer cells such as aspirin, ibuprofen, sulindac, phenylbutazone, naproxen, indomethacin, diclofenac, dexamethasone, celecoxib, and tamoxifen. 3. Improving depression and suppressing negative thoughts -- Alternative drugs: Prozac/Fluoxetine, Imipramine

A study published in 2011 in the journal Acta Poloniae Pharmaceutica showed that turmeric can be as effective as anti-depressant drugs for improving depression and reducing negative thoughts, without having the side effects of anti-depressant drugs.

4. Blood thinner -- Alternative drug: Aspirin:

A study published in the journal Arzneimittelforschung discovered that curcumin has anti-platelet and prostacyclin modulating effects of aspirin and can help to reduce the risk of heart attack or stroke without having the side effects of aspirin.

5. Destroying cancer cells -- Alternative drug: Chemotherapy

Studies show that turmeric can destroy and kill cancer cells. In 2007, a study published in the International Journal of Cancer showed that curcumin is as effective as oxaliplatin drug for treating colorectal cancer.

In another study published in the journal Breast Cancer Research and Treatment, researchers discovered that turmeric can target the cancer cells while leaving healthy cells unharmed. Also, another study published by researchers at University of Texas shows that turmeric is very effective in killing cancer cells and leaving healthy cells unharmed.

6. Diabetes -- Alternative drugs: Diabetes drugs such as Metformin

A 2009 study published in the journal Biochemitry and Biophysical Research showed that curcumin can be 500 times to 100,000 times (in the form known as tetrahydrocurcuminoids(THC)) more effective than diabetic drugs such as metformin. The researchers also concluded that turmeric can suppress glucose production in the liver and help diabetic patients.

In a study published in Annals of Indian Academy of Neurology, the researchers discovered that taking one-quarter of a teaspoon of turmeric extract or powder daily can improve the symptoms of Alzheimer's and dementia.

According to the researchers, curcumin is a powerful antioxidant and anti-inflammatory that can improve the cognitive functions in patients with AD. The authors suggest that “a growing body of evidence indicates that oxidative stress, free radicals, beta amyloid, cerebral deregulation caused by bio-metal toxicity and abnormal inflammatory reactions contribute to the key event in Alzheimer's disease pathology. Due to various effects of curcumin, such as decreased Beta-amyloid plaques, delayed degradation of neurons, metal-chelation, anti-inflammatory, antioxidant and decreased microglia formation, the overall memory in patients with AD has improved”.

8. Protecting the brain damage due to heavy alcohol consumption:

In a study at PanjabUniversity Institute of Pharmaceutical Sciences, the researchers found out that the potent antioxidant and anti-inflammatory molecule in turmeric known as curcumin can fight against chronic alcohol-induced cognitive dysfunction.

9. Anti-aging properties:

Studies show that the curcumin and its active metabolite, tetrahydrocurcumin (THC) could significantly increase the lifespan of three microorganisms including roundworms, Fruit flies and mice. According to the authors of the study, “given the long and established history of turmeric as a spice and herbal medicine, its demonstrated chemopreventive and therapeutic potential, and its pharmacological safety in model systems, curcumin, the bioactive extract of turmeric, promises a great future in human clinical studies designed to prevent and/or delay age-related diseases”.

10. Regenerating liver tissues:

In a study published in the Journal of the Medical Association of Thailand, the researchers discovered that primary polyphenol in turmeric, can repair and even regenerate the liver tissues of diabetic rats.

In conclusion, the studies show that the active compound in turmeric known as curcumin is as effective (in some cases even more potent) as pharmaceutical drugs. According to greenmedinfo.com, turmeric can be even more effective than the following lists of medical conditions and drugs:

Friday, 2 December 2016

Today's post from catherinecarrigan.com (see link below) discusses what Eckhart Tolle calls the 'pain body'. Now depending on your attitude towards mindfulness, alternative healing and ancient treatment techniques, you may either read this with horror, or allow yourself to be open to other ways of thinking about your chronic pain. I swing both ways in that regard and freely admit that I need to be in the mood for this sort of article. However, that doesn't mean that it doesn't have value - I think it does and if you can read the article and open yourself to new ways of approaching your pain, you may gain a great deal of benefit from it. A great many people have benefited from this sort of looking at your body, so don't be too quick in dismissing it as mumbo-jumbo. It's an interesting article, that after you've read it, seems to make perfect sense. Worth a read: it may get you thinking and if the pills aren't working at the moment, what have you got to lose?.

To free yourself from pain and suffering, you must have a deeper understanding of your pain body and the way it actually works.

What Your Body Really Is

To understand your pain body, you would need to understand the way that I, as a medical intuitive healer, view your whole body:You have a physical body, which includes your muscles, bones, glands and organs. You have an energy body, which includes your chakras, your acupuncture meridians and your breath. You have an emotional body, which includes your emotions and all your feelings including the ones you do not have words for quite yet. You have an intellectual body, which includes your mind, your thoughts and your beliefs. Finally, you have a spiritual body, which is the part of you beyond all space and time. Many people refer to this as your soul.

Simply put, your pain body is the same thing as your emotional body.

Emotions can shut down literally any other level of your being.

Don’t believe me?A Story of How Emotional Pain Changed Me Physically

Let me tell you a story.

In 2004 I was on vacation in Los Angeles.

I was driving a rental car in Santa Monica on the way to attend a yoga class when my cell phone rang.

Up until that point, I had spoken to him virtually every week of my life for 24 years. He had brought me through the hard times, the good times, he had helped me understand myself and been the father I always wanted and never had. And then he was gone.

Even though I was well rested, well fed and eager to practice yoga, when I arrived at the class, all I could do was lie on my mat barely able to move.

Suddenly I felt like all my energy had evaporated.

Perhaps you can relate a similar experience where a sudden emotional experience changed literally everything about you!

Simply understanding this fact can save you years of pain and suffering.

The Levels of Power In Your Body

You can think of each of these bodies as levels of power:Your soul controls your mind. That’s why, as we develop our spirituality, we can become mentally stronger and more capable of withstanding the vicissitudes of life. That is why many frail elderly people have become like spiritual warriors. Even though they may not be as physically strong as they used to be, they become a great source of strength for their entire community. Your mind controls your emotions. As you look for the wisdom rather than the hurt in all life’s challenges, you can save yourself tremendous emotional pain. That’s why thinking positively, looking on the bright side, having a sense of humor and reframing your challenges can soften the blows you feel emotionally. Your emotions control your energy. You can learn how to feel your feelings and let them go – as opposed to either running away from them through addictions like drugs (legal and illegal), alcohol, sex, overworking and the hundreds of other ways you can ignore what’s really going on. A good way to think of emotions is that they are a process. As you develop healthy stress management skills you can process through the inevitable hurts more easily. I often work with young teens and have tremendous compassion because they have not yet learned how to handle all their emotions and can quite easily be derailed by disappointment, divorce, death and the challenges of growing up. No matter what our age, the more you develop healthy methods of handling your emotions, the healthier you will be in every way. You can download a FREE chart about how stress affects your body at this link on my website. It’s quite humbling to learn what ailments are related to our inability to cope with the stress in our lives.Your energy body, which includes your chakras, your acupuncture meridians and your breath, controls your physical. That is why when your chi is depleted you can feel so physically weak.

Your Physical Body Is Simply Your Result

Your physical body is simply the densest part of who you are.

A good way to think of your physical body is that it is the result.

Your physical body is the result of your energy, your emotions, your mind and your soul.

By the time you experience pain and suffering, the causes of that pain and suffering have been with you for some time.

That’s because energy enters in through your spiritual, filters down into your mind, then your emotions, then your energy body and finally congeals in your physical body.

If I am working with a client to relieve pain and suffering, I have to reverse the process.

That means you have to move the vibration of pain and suffering back out of your physical, through your energy, through your emotions, through your mind and all the way past your spiritual self.

Simply put, pain comes in through your spiritual, past the gateway of your mind, into your emotions where things can get quite tumultuous, through your energy and finally into your physical organs, glands, bones and muscles.

To get rid of pain, you have to reverse the process.

That’s why – if you have only been working to get rid of pain through your physical body – you may not have been too successful.

You have to honor who you really are and take into account all five bodies to get rid of your pain and suffering.

How Energy Flows In Your Body

Yesterday I was working with a new client who had been suffering from chronic low back pain.

Although she had worked regularly with a chiropractor, massage therapist and cranio sacral therapist, improved her nutrition and started practicing yoga, nothing could get rid of the chronic nagging pain on the right side.

She came to me for a medical intuitive reading.

Very quickly I explained that 30 percent of her pain was due to a low functioning right kidney, 40 percent due to severe adrenal burnout and the last 30 percent due to spiritual loneliness as her soul was longing for companionship of like-minded people.

Even though she is happily married, has two well-behaved children and a fulfilling part-time job, she admitted she had been longing for people she could really talk to about the things that her soul had begun to perceive.

“If you think I’m tired now you should have seen me years ago,” she told me.

Her self care and great attitude had indeed made a difference, but not cleared her low back pain completely.

I explained to her the way energy flows in the body: Energy enters at the crown of your head through the bahui point. The hara line is a vertical electrical current running through the bahui all the way down into the center of the earth. Any breaks, blowouts or disruptions in your hara line can lead to major disruptions in the flow of your energy. I can heal your hara line and also teach you how to perceive it and heal it yourself. Your hara line feeds energy into your chakras. People who practice energy exercise such as yoga, tai chi and qi gong are doing themselves a wonderful favor by balancing the energy centers in their bodies. This is why I have taught yoga for 20 years and practiced and taught qi gong for about as long. Although these forms of exercise may be gentle, their benefits are quite profound. The more balanced your chakras, the more balanced your endocrine system and every organ system in your body will be. In addition to energy exercise, you can visit a highly trained energy healer such as myself to clean out and repair your chakras.Your chakras feed your acupuncture meridians. I practice acupressure (without needles) as well as Reiki and other forms of energy healing. A block in your acupuncture meridians may be the cause of your pain. Your acupuncture meridians feed your organs. In the case of my client, after all her chiropractic, massage, craniosacral therapy, yoga and good nutrition, it was a surprise for her to hear that her right kidney and right adrenal gland was partially the source of her pain. Energy work – whether it be energy exercise or energy healing – can build the chi in your organs. Your organs feed your muscles. If you have a chronic muscle pain, you can learn which organs that muscle is related to. If you want to understand the health of your organs, you can download this FREE assessment on my website at this link. The healthier your organs, the less pain you will feel.

Your entire body is like one big hologram with each aspect deeply interrelated to other aspects of yourself.

When you suffer pain, the more you inquire about how these different aspects correlate, the more likely you are to root out the causes and resolve the issue.

Every Organ Carries Emotions That May Be Adding to Your Pain Body

If you visit my website, you can download a FREE chart that lists out the emotions that correlate with the major organs in your body. Just click on this link.

The muscles that it correlates with include your quadratus lumborum muscle in your lower back as well as your hamstrings. If you have low back pain, more than likely these muscles are highly involved in your suffering.

That is why if you came to me for corrective exercise and therapeutic yoga for low back pain, more than likely I would recommend exercises to lengthen your hamstrings and balance the two sides of your quadratus lumborum muscles.The emotions associated with your large intestine include: Guilt Grief Regret Release Self worth (or lack thereof) Enthusiasm Depression Letting go Indifference (Un)merciful Compassion Sadness Apathy

Now Here’s the Truth: What You Experience Is In You, Not Out There

Most of the time we believe that world outside of us is the cause of the emotions that we feel.

As a long-time medical intuitive healer, I am here to tell you the truth.

What you feel is inside of you.

If you feel angry, you will look out into the world and find things to feel angry, bitter and upset about.

If you feel depressed, you will look out and find 100 reasons to feel sorrowful.

As you change your inner experience, the world you experience changes also.

You Can Not Get Rid Of Your Pain Until and Unless You Shift Your Emotions

If I am doing a healing – no matter whether that healing is to get rid of the pain in your back, help you improve your business, get to the bottom of your money issues or to improve your relationship with your mother – after setting the goal, the very next thing I do is find the emotion or emotions that have kept your suffering in place.

Why is this so important?

Simply put, you can not get rid of your pain until and unless you have resolved the emotions that have held it in place.

If you don’t, you simply morph that energy from one part of the body to another.

As you resolve these emotions in yourself, you stop carrying the vibration.

As you stop feeling these emotions, you stop lighting up the parts of your brain related to the acupuncture meridians.

As you clear this energy from all parts of your body, you start feeling lighter and less bothered by the pain.

This is why integrated holistic healing is a must in this day and age.

This is why, as a medical intuitive healer, I work on all five bodies – your spiritual, intellectual, emotional, energetic and physical self.A Personal Story

In in the fall of 2015, I was practicing my yoga when I noticed that my left wrist was hurting. I had just come out of a full wheel. Even though I had learned the correct form so as not to strain my wrist, I felt a sharp shooting pain.

As busy as I was, I didn’t pay much attention until a few months later when I was practicing qi gong.

I lifted my left wrist and noticed a large protruding bump – a ganglion cyst.

It turns out that my mother also has a ganglion cyst, also known as a Bible bump because an old timey remedy is to hit it with a large heavy Bible to get rid of the bump. Turns out her ganglion cyst is in the exact same place as mine only hers isn’t hurting any longer.

“I’m 57 years old and I can still blame something on my mommy,” I joked with my yoga class.

Indeed, many of the vibrational patterns that cause our pain and suffering did not in fact start with us. These are called: Genomes, or genetic thought patterns. Miasms, or beliefs, habits and thought patterns that we picked up from the culture we grew up in.

I identified the emotion behind my wrist pain and began taking a flower essence to resolve the feelings.

Even if the pattern had in fact started with my mother, it was now in my own cells and if I wanted to resolve the pain I had to deal with it.

As I did so, I also received chiropractic adjustments as my carpal bones had become misaligned.

Eventually the pain lessened.

Then one day I noticed I had run out of the flower essence I had been taking to resolve the emotions behind my wrist pain.

Thinking I may be over it by now, I didn’t bother to start on my second bottle.

A few days after I ran out, I noticed my wrist pain had returned!

I immediately began taking the second bottle and continued to process the emotions that had made me hurt so badly.

To Get Rid of Pain, You Must Take An Integrated Approach

You can take an aspirin, call your chiropractor, visit your medical doctor for an Xray or an MRI. I strongly support all these approaches and can also recommend many natural healing remedies for pain.

But when you really want to get rid of pain and suffering, you will want to take an integrated approach.

Ask yourself: Where did my pain start? What are the emotions I am feeling? How are my spiritual, intellectual, emotional, energetic and physical bodies involved in this pain?

By taking an integrated approach, you can supercharge your healing, resolve your emotions, shift the vibration and empty out your pain body.

What is healing?

Healing happens when you honor who you really are as a human being and take advantage of this deeper knowledge to address all aspects of yourself.

Thursday, 1 December 2016

Today's post from sciencedaily.com (see link below) could be an astonishing breakthrough in the battle against neuropathic pain. It discusses research on certain compounds that can modify the brain's cannabis receptors to reduce chronic pain symptoms, without the need for cannabis itself, or strong opioid-type drugs and most importantly, without any side effects! The science in the second half of the article may leave you somewhat baffled but the message in the first half is easy to understand. What's ironic is that the current hysteria about opioid addiction and overdose deaths has been the trigger for this research. This reflects the current state of medical research: if there's enough demand (the 'disease' becomes widespread or the group of patients grows enormously) suddenly money appears for research and development. Never underestimate the pharmaceutical industry's ability to sniff out profits! That's not very encouraging for people with rare diseases or those who belong to a small group of patients but in our case, we have 20 million Americans with neuropathy and a media hype over opioid abuse and its consequences - a double stimulus to pour money into research. That's why we're suddenly seeing advances in research regarding nerve pain and its treatments, even if they are only tested on long-suffering rodents - it's about time!!

Compound suggests chronic pain treatment without opioid or medical marijuana side effectsNovember 15, 2016 Source: Indiana University FULL STORY

Indiana University neuroscientist Andrea Hohmann took the stage at a press conference Nov. 14 in San Diego to discuss research conducted at IU that has found evidence that the brain's cannabis receptors may be used to treat chronic pain without the side effects associated with opioid-based pain relievers or medical marijuana.

The study was discussed during the annual meeting of the Society for Neuroscience, the world's largest source of emerging news about brain science and health. Hohmann was joined by three other international researchers whose work focuses on similar topics.

"The most exciting aspect of this research is the potential to produce the same therapeutic benefits as opioid-based pain relievers without side effects like addiction risk or increased tolerance over time," said Hohmann, a Linda and Jack Gill Chair of Neuroscience and professor in the IU Bloomington College of Arts and Sciences' Department of Psychological and Brain Sciences.

Chronic pain is estimated to affect nearly 50 million adults in the United States. The rise in opioid-based pain relievers to treat chronic pain has also contributed to an opioid addiction epidemic in the United States, with 19,000 deaths linked to prescription opioid abuse in 2014. In Indiana, the use of needles associated with prescription opioid abuse led to a major HIV outbreak in the state's southeastern region, prompting the governor to declare a public health emergency in 2015.

"The fact that deaths associated with prescription opioid abuse have surpassed cocaine and heroin overdose deaths combined is a significant factor in exploring cannabinoids as an alternative treatment for pain," said Richard Slivicki, a graduate student in Hohmann's lab who led the study. "It's a major epidemiological crisis, and one that helps motivate our work."

The IU study found that a compound that modulates the activity of the brain's receptors for THC and endocannabinoids reduced chronic pain in mice. THC, or tetrahydrocannabinol, is the main psychoactive ingredient in marijuana; endocannabinoids are natural pain-relieving compounds released by the brain.

These modulating compounds, called positive allosteric modulators, or PAMs, work by binding to a recently discovered site on a cannabinoid receptor in the brain called CB1, which is different from the site that binds THC. The PAMs were synthesized by Ganesh A. Thakur at Northeastern University, who is a collaborator on the study.

The IU scientists specifically tested the effects of CB1 PAM on neuropathic pain, a type of chronic pain caused by nerve damage, which is estimated to affect as many as 40 percent of cancer patients as a side effect of chemotherapy. The scientists gave mice paclitaxel, a chemotherapy drug known to damage nerves and cause pain, and then treated them with CB1 PAM.

After receiving paclitaxel, mice became hypersensitive to both mechanical and cold stimulations to the paw, indicating increased pain. After treatment with the CB1 PAM, the mice behaved like normal mice that did not experience pain.

The study also found evidence that the use of CB1 PAM amplified the therapeutic effect of endocannabinoids without the negative side effects of a "marijuana high," such as impaired motor function. The PAMs were administered in combination with a compound to increase endocannabinoid levels in the brain by preventing their breakdown in the body.

Moreover, the team found that the use of the CB1 PAM remained effective over time to prevent pain in mice, as opposed to THC and endocannabinoid breakdown inhibitors, both of which stopped working with repeated dosing.

"We found that the compound did not produce reward on its own, so it's unlikely that a CB1 PAM would be abused as a recreational drug," Hohmann added. "Our studies show that we can maintain or preserve therapeutic efficacy in ways that we haven't seen with some of the other classes of analgesics that are used in the clinic."

The event was titled "Targeting the Brain's Cannabinoid System."Story Source:

Wednesday, 30 November 2016

Today's post from ireadculture.com (see link below) provides a little more information regarding CBD patches for neuropathy relief. Following on from another recent article here on the blog, this one is (if we're being honest) little more than an announcement/advertisement for the company currently producing these patches. However, many people already swear by smoked cannabis or CBD oil and claim that it really helps with their nerve pain. Like everything else with neuropathy treatments, the individual must decide if it helps them or not but there are three main advantages to a transdermal patch delivery system: 1) you can put it on easily and then forget about it; 2) you don't have to smoke anything and 3) you don't get high (that may be a 'disadvantage' for some😊). It seems likely that we're at the beginning of something big here, as more and more medical benefits of cannabis are found...time will tell. It's also true that greater development of products will lead to a reduction in prices.

Although cannabis is still considered to have no medical use by the Drug Enforcement Administration, pharmaceutical companies continue to create medications that prove its efficacy against countless ailments. Cannabis Science, Inc. has developed two new pain relief patches that are specifically for patients with Diabetic Neuropathy nerve pain and Fibromyalgia.

Fibromyalgia is a medical condition in which the individual experiences chronic widespread pain and a higher, more painful response to pressure. Neuropathy damages or spreads disease to nerves and can have various painful effects depending on which nerves are affected. Now patients facing either of these ailments might find relief with the transdermal CBD patches created by Cannabis Science.

The transdermal pads are made with high potency cannabinoid (CBD) extract. The extract is released in a controlled fashion, which enters into the bloodstream through a medicated adhesive patch that is put on the skin. The CBD extract enters through the skin and into the central nervous system, which is how patients receive pain relief.

The Cannabis Science CEO, Raymond C. Dabney, confirmed that these developments are just the beginning for his company, according to www.biospace.com. “The development of these two new pharmaceutical medicinal applications are just the tip of the iceberg for what we see as the future of Cannabis Science,” Dabney said. “While we strive to increase our land capacity for growth and facilities to produce our own product to supply our scientists with proprietary materials to make these formulations, we are so busy researching more potential needs for cannabis-related medical applications and developing the methods for delivery of these medications.”

CBD is notorious for being one of the active ingredients in cannabis that leads to various healing properties from helping to reduce seizures to acting as an anti-inflammatory and pain reliever. One of its most attractive properties to many is that it does not have any psychoactive properties. As more states vote soon on allowing medical cannabis programs in their state, Cannabis Science only sees greater opportunity to help more patients.

“As more states nationwide legislate for the legalization of cannabis and cannabis derived medications, we here at Cannabis Science are focused on developing pharmaceutical formulations and applications to supply the huge growing demand expected over the coming few years,” Dabney said.

Tuesday, 29 November 2016

Today's post from dressamed.com (see link below) tries to explain what the characteristics of a few sorts of neuropathy are. One of the first things we hear when we try to research neuropathy is, that there are over 100 types and over 100 causes. It generally stops there but most of us want a little more information than just the bare facts, This article looks at probably the 7 most common forms of neuropathy and gives a short description of each. In the confusion after hearing a diagnosis of neuropathy, most people are left bewildered as to exactly what's wrong with them and why. This article helps set a few things straight and hopefully helps many nerve damage patients better understand why they're suffering so much. The authors admit themselves that it's a limited choice but it's better than no choice at all.

Neuropathy, also known as peripheral neuropathy, is a disease often associated with diabetes, although there are actually more than 100 known types of neuropathy – each with its own characteristic symptoms, pattern of development, and prognosis. Although there are several “tell-tale” symptoms that seem to afflict all neuropathy sufferers, each version of the disease is different and comes with its own set of problems.

Below are several of the main types of neuropathy, although this is not an exhaustive listing by any means.DIABETIC NEUROPATHY — Over 30% of all neuropathies can be linked to diabetes, and diabetes is the most common cause of neuropathy in the western world. Both Type 1 and Type 2 diabetes can lead to diabetic neuropathy – high blood sugar levels damage the nerves and neuropathy is one of the outcomes.IMMUNE MEDIATED/CIDP — manifestations of neuropathy such as CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) is caused by an abnormal immune system response. In this condition, nerves swell and become irritated due to an immune reaction, eventually damaging the nerves outside the brain or spinal cord with peripheral neuropathy symptoms thus following.HEREDITARY NEUROPATHY — Diseases like Charcot-Marie-Tooth have been discovered to be inherited and lead to hereditary neuropathy. This condition deals with the role of different proteins in the role of physiology in peripheral nerve conduction.AUTONOMIC NEUROPATHY — actually a group of symptoms more than a disease itself, autonomic neuropathy concerns damage to the nerves of the body that control every-day functions in the body that are autonomic in nature, such as blood pressure, heart rate, bowel and bladder emptying, even digestion. When the nerves that control or affect these functions are disrupted, these autonomic functions cease to perform normally and can cause many complications.COMPRESSIVE NEUROPATHY — Known to laymen as a “pinched nerve,” compressive neuropathy often comes about by an accidental injury to the body. Herniated discs, sciatica, arthritis in the spine and spinal stenosis are just some of the ways a nerve can become compressed and cause pain and discomfort to an afflicted sufferer. DRUG-INDUCED/TOXIC NEUROPATHY –– toxic polyneuropathies come about in the human body when nerves are damaged or destroyed by chemicals introduced that have cumulative or highly-toxic effects. These tend to be occupational, chance exposures or intentional, even homicidal ingestions.

There are other forms of neuropathy, including those from infectious diseases such as shingles, as well as from nutritional deficiencies. The best bet for understanding any form of neuropathy that a person may be experiencing is to visit their doctor or a trained neurologist for a consultation.About The Author

Brian M McLauren is an expert author in Neuropathy. To gain a better understanding of the many neuropathy causes, or if you are experiencing any neuropathy symptoms, please consult your physician.

Monday, 28 November 2016

Today's post from medscape.com (see link below) refers to diabetes and neuropathy but because the treatments discussed here are all used to treat other neuropathies from other causes, it's still extremely relevant to neuropathy patients across the board. It regrets the fact that even approved medications for nerve damage can be ineffective, depending on the patient but concentrates here on some common, so-called nutraceuticals for neuropathy. Nutraceuticals, are non-pharmaceutical approaches to nerve pain and we should be grateful that respected sites such as Medscape are prepared to look at these things objectively and honestly. After all, we the patients, either benefit or are failed by the many options on the market. The article gives an honest assessment of various of these treatments that are commonly used by neuropathy patients but it's by no means all - there are many, many other options that are not put under the microscope here. Nevertheless, we must be grateful for all information on the non-pharmaceutical treatments we can get - it's for our benefit in the long run. Look out though, you may be disappointed with some of their findings. Worth a read if you take any of the ones mentioned here.

There is currently no specific treatment approved for diabetic neuropathy, a huge unmet clinical need since up to half of all patients with diabetes will eventually develop neuropathy.

Part of the problem is that there is no clear path to successful approval of any such agents, with ongoing arguments about which clinical end points would be most relevant in trials. The only therapeutic strategy shown to prevent development or curtail progression of neuropathy is tight glucose control.

There are, however, numerous therapeutics for the pain associated with this complication, which is said to affect up to a quarter of all patients with diabetic neuropathy to the extent that it "produces considerable disability and is challenging to assess and manage," according to a recent review of neuropathy in diabetes, led by Solomon Tesfaye, MD, professor of diabetic medicine at University of Sheffield, United Kingdom (Medicine. 2015;43:26-32).

But even the approved treatments for diabetic neuropathy pain are not ideal.

"None affords complete relief, even when used in combination," according to the latest American Diabetes Association Standards of Care, published at the beginning of this year.

As a result, there is growing interest in nonpharmaceutical approaches to the treatment of both diabetic neuropathy itself and the associated pain, with a plethora of vitamins, vitamin complex combinations, and other agents emerging that purport to affect this debilitating complication of diabetes.

But what is the scientific evidence that these "nutraceuticals" can actually help? Medscape Medical News surveyed several experts in the field to garner their views.

"The problem is there is no unequivocal evidence based on randomized controlled trials that [nutraceuticals] slow or reverse nerve damage in diabetes," Dr Tesfaye told Medscape Medical News.

But he says there may be a rationale for the use of certain vitamins in patients with diabetic neuropathy who are actually deficient — such as vitamin D or vitamin B12 — and such people may benefit from injections of these vitamins.

Dr Brian C Callaghan, MD, from the University of Michigan, Ann Arbor, echoes these thoughts: "Vitamins can be effective in treating neuropathies that are due to vitamin deficiencies; unfortunately, most neuropathies are not caused by a vitamin deficiency."

No nutraceuticals are approved by the European Medicines Agency (EMA) or the US Food and Drug Administration (FDA), for the treatment of diabetic neuropathy or associated pain, but several such products are available over the counter.

Treating Vitamin D or B12 Deficiencies

Dr Tesfaye says there is "a clear rationale for replacing vitamin D and B12 if there is a deficiency," which is common in colder countries such as the United Kingdom, which has limited sunshine in the winter (and which therefore has an effect on vitamin D levels) and where patients with diabetes commonly receive metformin (which can lower levels of vitamin B12).

"There is, however, no evidence that these are helpful if individuals have normal levels of these vitamins," he cautioned.

Recent research conducted in Pakistan by Abdu Basit, MD, at the Baqai Institute of Diabetology & Endocrinology in Karachi, and colleagues showed that a single, high dose of intramuscular vitamin D was safe and effective for patients with painful diabetic neuropathy (BMJ Open Diabetes Res Care. 2016;4:e000148).

Pain scores improved the most at 10 weeks and remained lower than baseline levels until the study end at 20 weeks. Significant effects were seen on the Douleur Neuropathique 4 score, the McGill pain score, and the McGill Pain Questionnaire Score (all P < .0001).

However, the researchers admit that the lack of a placebo group is a major study limitation, and they call for a longer, placebo-controlled study to assess the optimal dose and safety and efficiency of vitamin D in painful diabetic neuropathy. It would also be useful to assess the administration of vitamin D in diabetic neuropathy per se, they add.Divided Opinion on α-Lipoic Acid and the NATHAN 1 Study

Another nutraceutical claimed to be of some benefit in diabetic neuropathy is the antioxidant α-lipoic acid (ALA, also known as thioctic acid), which is approved for use in Germany for neuropathic pain.

In a large study called NATHAN 1, Dan Ziegler, MD, from the Leibniz Center for Diabetes Research, in Düsseldorf, Germany, and colleagues randomized 460 patients with mild to moderate diabetic distal symmetric sensorimotor polyneuropathy to receive 600 mg/day of α-lipoic acid (Thioctacid HR, MEDA Pharma) or placebo for 4 years (Diabetes Care. 2011;34:2054-2060).

The study failed to meet its primary efficacy end point (a composite of pain scores) or improve nerve conduction.

But the patients treated with α-lipoic acid did have improvements in some symptoms and less progression of impairment, compared with patients who received placebo, and the agent was well tolerated.

In a post hoc analysis published earlier this year (J Diabetes Complications. 2016;30:350-356), Dr Ziegler and colleagues show that patients with normal baseline blood pressure and weight, but older age, longer duration of diabetes and neuropathy, and a history of CVD were less likely to have progression of neuropathic impairment after 4 years of treatment with α-lipoic acid than those on placebo.

And patients who also received ACE inhibitors were more likely to have improved heart rate during deep breathing (a measure of cardiac autonomic function).

"Thus, the drug may be particularly suitable for the elderly patient with a history of CVD and ACE-inhibitor treatment and both more severe diabetes and neuropathy who cannot meet individualized glycemic targets," the researchers say.

In other words, the worse a patient was, the better they responded to treatment with ALA.

Dr Ziegler told Medscape Medical News that this α-lipoic acid is warranted for "all diabetic patients with neuropathy, [and patients] can expect symptom relief, slowing of neuropathy progression, or even improvement at a dose of 600 mg/day."

However, Drs Tesfaye and Callaghan beg to differ and stress that the evidence to support use of the oral version of α-lipoic acid is weak.

"The NATHAN 1 trial results showed that the primary end point of [improvement in] composite neuropathy score was not achieved," Dr Tesfaye cautioned.

However, there is some clinical trial evidence for efficacy of the intravenous version of α-lipoic acid (Diabetes Care. 2010;33:2285-2293), he said.

Dr Callaghan agreed that "α-lipoic acid has some evidence for the treatment of painful diabetic neuropathy, but the evidence is not strong."

Vitamin Combinations: Metanx and NutriNerve

There are also products that combine different B vitamins and purport to be effective in diabetic neuropathy and its associated pain, but clinical-trial evidence for efficacy of any of these is currently sparse.

In the study — published by Vivian A Fonseca, MD, professor of medicine and pharmacology, Tulane University Health Sciences Center, in New Orleans, Louisiana, and colleagues — the 214 patients were randomized at centers in Alabama, Louisiana, Nebraska, and Texas to receive this B vitamin combination or placebo daily for 24 weeks.

Metanx did show a clinically significant improvement in Neuropathy Total Symptom Score (NTSS-6), a secondary end point, among those taking Metanx compared with those on placebo.

"Metanx appears to be a safe and effective therapy for alleviation of peripheral neuropathy symptoms, at least in the short term," Dr Fonseca and colleagues conclude, noting that the trial may have been too short to show an effect on vibration-perception threshold. "Further longer studies are needed," they said.

In an email to Medscape Medical News, Dr Fonseca said nutraceuticals such as vitamin D, B vitamins, alpha-lipoic acid, or combinations of vitamins such as Metanx may "help some patients [with diabetic neuropathy], but there is no clear indication" for them.

"There are very few good studies…[but] not enough for FDA approval," he stressed.

However, in an editorial accompanying Dr Fonseca's 2013 paper, Aaron Vinik, MD, director of research and the neuroendocrine unit at Eastern Virginia Medical School and Strelitz Diabetes Research Center, in Norfolk, suggested that vibration-perception threshold was not a suitable end point for the study (Am J Med. 2013;126:95-96).

"Currently…the only agents approved for the treatment of symptomatic diabetic peripheral neuropathy in the US are duloxetine and pregabalin, which do not affect nerve conduction, have mechanisms of action unrelated to the pathophysiology of diabetic neuropathy, and only address pain relief," Dr Vinik wrote. (There is a third medication approved in the United States for diabetic neuropathy pain, an opioid called tapentadol.)

Dr Vinik stressed that patients who received Metanx did report improvements in NTSS-6 (based on numbness, tingling, and aching, burning, or lancinating pain; P = .013) and allodynia (P = .033 at week 24), and in components of an SF-36 mental health survey.

Indicating that NATHAN 1 showed that α-lipoic acid "improves many of the symptoms of neuropathy if you treat for long enough, usually 4 years," he told Medscape Medical News that NutriNerve "is very effective for patients [with painful diabetic neuropathy and] symptoms of numbness, tingling, and burning."

Patients also comment that their skin is less dry, their nails are less brittle, and their hair grows more, he noted.

But according to Dr Callaghan, Metanx and NutriNerve "each have different vitamin cocktails that are purported to help nerves, [but] there is no strong evidence to support the use of either….I do not think that there is a good scientific rationale for their use," he asserted.

"Upcoming guidelines [are unlikely to] recommend nutraceuticals because of the lack of strong evidence to support their use," Dr Callaghan concluded.

Recommendations for Drugs for Painful Diabetic Neuropathy

The most recent American Diabetes Association (ADA) Standards of Care recommend optimizing glucose control to prevent or delay the development of neuropathy in patients with type 1 diabetes and to slow the progression of neuropathy in patients with type 2 diabetes. Patients with type 1 diabetes for 5 years and all patients with type 2 diabetes should be assessed annually for diabetic peripheral neuropathy, it adds.

However, specific treatment for the underlying nerve damage is currently not available, it notes.

Yet "several medications have been demonstrated to be effective for the treatment of pain associated with [diabetic peripheral neuropathy], but there is limited clinical evidence regarding which medication is most effective for an individual patient," the ADA notes.

In 2010, the European Federation of Neurological Societies recommended using tricyclic antidepressants (TCAs, such as amitriptyline or imipramine), antiepileptic medications (such as gabapentin or pregabalin) and serotonin-norepinephrine reuptake inhibitors (SNRIs, such as duloxetine and venlafaxine) as first-line agents to treat painful diabetic neuropathy. Tramadol or stronger opioids are recommended as second- or third-line medications.

In 2011, the International Toronto Expert Panel on Diabetic Neuropathy issued similar guidance.

The FDA has approved three medications for the treatment of pain associated with diabetic peripheral neuropathy (pregabalin, duloxetine, and tapentadol), "but none affords complete relief, even when used in combination," according to the ADA Standards of Care.

The EMA has also approved pregabalin and duloxetine and, more recently, capsaicin patches (Qutenza, Astellas Pharma) for diabetic neuropathy pain.

Although tricyclic antidepressants, gabapentin, venlafaxine, carbamazepine, and tramadol are not officially approved for treating painful diabetic neuropathy, they may be effective, and clinicians may consider using them to treat patients with this condition, the Standards of Care continues.

"Comparative efficacy studies and trials that include quality-of-life outcomes are rare, so treatment decisions must consider each patient's presentation and comorbidities and often follow a trial-and-error approach," it advises.

"Given the range of partially effective treatment options, a tailored and stepwise pharmacological strategy with careful attention to relative symptom improvement, medication adherence, and medication side effects is recommended to achieve pain reduction and improve quality of life."

Search This Blog

Aim of the Blog

http://www.thebody.com/content/65006/hiv-and-neuropathy-how-to-avoid-becoming-a-nervous.htmlThe aim is to exchange news, information, experiences, tips and hints about the disease and its treatment. There is relatively little information on the web for patients who have both HIV and neuropathy, so maybe something you read here or on the website will help you live with the condition more comfortably. All constructive, helpful (or even downright funny... we all need a laugh!) comments are welcome.

Feel like contributing to the Blog?

By using the Contact button in the menu above, you can contribute comments, posts, questions...in fact anything you think might be of interest to our readers.

All comments of a non-commercial nature are welcome but if you make a comment on a post that is published on this blog:-

Please reference the content you are commenting on unless this is personal information. This means stating the title of the post and the text you are referring to. This makes it easier for both the reader of your comment and the original author of the post to understand the points you are making.

About Me

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only. Use of this site should in no way replace the consultation of a skilled professional. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website. We are not responsible or liable for any advice, course of treatment, diagnosis or any other information, services or products that you obtain through this website.

The contents of articles are the responsibility of the original writers and the original source. The contents are provided as an information source only and are only edited to fit the Blogger format - no content is changed in that process.

Comments can be made via the 'comment' facility and will be treated with discretion (no names or email addresses will be open to the public. However, any complaints about article content must be taken up with the original author or source (a link is always provided under each article).

As moderator I reserve the right to remove any offensive material submitted in comments and will not allow the comments facility to be used for advertising.

This site respects the legal requirements, including thoseconcerning medical and personal information privacy, that apply in the Netherlands.

Follow by Email

This site provides medical/health information or advice by means of articles gathered from across the Internet. These articles are always referenced back to their original URL. Some articles do not have a specific author but are produced by the organisation/hoster/webteam of the original site - going back to the original site will confirm this. All posts on this Blog are visible to everyone. Any author, of either a post, article, video, or a comment can have their post removed immediately if they so wish, by contacting the moderator by email: drew50@chello.nl. (Please give a clear reference to the article or text in question.) Modification of article content is only possible at the original source (see link under each post). If you wish your modifications to appear here, then once again, an email will ensure that is done.

I use content under the FAIR USE policy. I do not own any image, audio or video shown; they belong to the respective owner(s).